The Effects of Free Maternal Health Policy on Quality of Maternal Health Care in Kenya: A Case Study of Pumwani Maternity Hospital, Nairobi.

Abstract

Maternal mortality remains a major global public health concern which can be reduced significantly by access to timely and quality obstetric care. The Government of Kenya, in 2013, initiated a free delivery policy to mitigate high maternal mortality. This case study was undertaken at Pumwani Maternity Hospital- Kenya in 2014, a year after the free maternity services were initiated, to investigate the effects of the policy on access, utilization patterns and quality of maternal health services. Women of child bearing age attending the hospital for maternal health services and health workers at the hospital were sampled using purposive and simple random sampling procedures. Quality of care was investigated using questionnaires, focused group discussion, case notes examination and a quality indicators’ observation checklist. Results revealed staff shortage; inadequate physical infrastructure, supplies and equipment; long waiting times and nasocomial infections as factors that compromised quality of maternal care. The researcher concluded that though the free delivery policy in Kenya was implemented without consideration for infrastructure and resources’ support, it has the potential to reduce social exclusion associated with financial barriers to health care. The researcher recommended the inclusion of comprehensive maternal health services in the free delivery policy, besides improvement in staffing levels, infrastructure and supplies. Quality of care must also be addressed at micro (health facility) and Macro (Ministry of Health) levels and secure funding put in place to ensure that the free delivery policy is sustainable.